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Effects of risk factors for and components of metabolic syndrome on the quality of life of patients with systemic lupus erythematosus: a structural equation modeling approach

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Abstract

Purpose

This study assessed the relationships among the risk factors for and components of metabolic syndrome (MetS) and health-related quality of life (HRQOL) in a hypothesized causal model using structural equation modeling (SEM) in patients with systemic lupus erythematosus (SLE).

Methods

Of the 505 SLE patients enrolled in the Korean Lupus Network (KORNET registry), 244 had sufficient data to assess the components of MetS at enrollment. Education level, monthly income, corticosteroid dose, Systemic Lupus Erythematosus Disease Activity Index, Physicians’ Global Assessment, Beck Depression Inventory, MetS components, and the Short Form-36 at the time of cohort entry were determined. SEM was used to test the causal relationship based on the Analysis of Moment Structure.

Results

The average age of the 244 patients was 40.7 ± 11.8 years. The SEM results supported the good fit of the model (χ 2 = 71.629, p = 0.078, RMSEA 0.034, CFI 0.972). The final model showed a direct negative effect of higher socioeconomic status and a positive indirect effect of higher disease activity on MetS, the latter through corticosteroid dose. MetS did not directly impact HRQOL but had an indirect negative impact on it, through depression.

Conclusions

In our causal model, MetS risk factors were related to MetS components. The latter had a negative indirect impact on HRQOL, through depression. Clinicians should consider socioeconomic status and medication and seek to modify disease activity, MetS, and depression to improve the HRQOL of SLE patients.

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Funding

This work was supported by the Research Program funded by the Korea Centers for Disease Control and Prevention (2014-E63002-00).

Author information

Authors and Affiliations

  1. Department of Rheumatology, Chonnam National University Medical School & Hospital, 42 Jebong-ro, Dong-gu, Kwangju, 61469, Republic of Korea

    Jeong-Won Lee, Ji-Hyoun Kang, Kyung-Eun Lee, Dong-Jin Park & Shin-Seok Lee

  2. Department of Internal Medicine, Chungnam National University School of Medicine, Taejon, Republic of Korea

    Seong Wook Kang

  3. Division of Rheumatology, Department of Internal Medicine, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Seung-Ki Kwok

  4. Department of Internal Medicine, Catholic University of Daegu School of Medicine, Taegu, Republic of Korea

    Seong-Kyu Kim & Jung-Yoon Choe

  5. Department of Rheumatology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Republic of Korea

    Hyoun-Ah Kim

  6. Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Republic of Korea

    Yoon-Kyoung Sung

  7. Department of Internal Medicine, Metropolitan Government–Seoul National University Boramae Medical Center, Seoul, Republic of Korea

    Kichul Shin

  8. Department of Internal Medicine and Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Gyeongnam, Republic of Korea

    Sang-Il Lee

  9. Division of Rheumatology, Department of Internal Medicine, School of Medicine, Wonkwang University, Iksan, Republic of Korea

    Chang Hoon Lee

  10. Division of Rheumatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea

    Sung Jae Choi

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  1. Jeong-Won Lee
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  11. Kichul Shin
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  12. Sang-Il Lee
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  13. Chang Hoon Lee
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  14. Sung Jae Choi
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  15. Shin-Seok Lee
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Corresponding author

Correspondence to Shin-Seok Lee.

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Conflict of interest

All the authors have no conflicts of interest to declare, including relevant financial interests, activities, relationships, and affiliations, relating to this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Review Board/Ethics Committee of Chonnam National University Hospital (IRB no. CNUH-2015-250) and with the 1964 Helsinki declaration and its later amendments. Informed consent was obtained from participants at the time of registry for enrollment.

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Lee, JW., Kang, JH., Lee, KE. et al. Effects of risk factors for and components of metabolic syndrome on the quality of life of patients with systemic lupus erythematosus: a structural equation modeling approach. Qual Life Res 27, 105–113 (2018). https://doi.org/10.1007/s11136-017-1689-z

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